Provider Demographics
NPI:1770946105
Name:WARD, KINDIS (PLMHP, MSCC)
Entity type:Individual
Prefix:
First Name:KINDIS
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:PLMHP, MSCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7319 N 143RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-2133
Mailing Address - Country:US
Mailing Address - Phone:402-917-7105
Mailing Address - Fax:
Practice Address - Street 1:7319 N 143RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68142-2133
Practice Address - Country:US
Practice Address - Phone:402-917-7105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10832103TC0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical